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We must stop turning a blind eye to pain killers

Roar Guru
28th September, 2015
19

Medical knowledge of the long-term effects of repeated concussions is nothing new. As far back as 1928 doctors recognised the so-called ‘boxer’s dementia’.

Also known as Dementia Pugilistica, it is a neurodegenerative disease that was first noted in boxers in the 1920s, but later also in wrestlers and other sportsmen who had suffered repeated concussion.

The condition (DP) may manifest as dementia, declining mental ability, lack of co-ordination, problems with memory, and Parkinson’s disease. These are some of the symptoms suffered by an estimated 15 per cent of professional boxers (according to the International Journal of Psychiatry in Medicine) and an increasing number of NFL players (some of whom have considered a class action against the league).

So, one can understand the recent moves by the NRL to follow the lead of the NFL in putting in place rules and mechanisms to deal with concussion.

One of the intriguing aspects of the concussion debate is the idea that the NRL must (in the words of Ron Muratore, former head doctor of the NSWRL) “protect players from themselves”.

This recognises the fact that most NRL players will seek to stay on the field, despite being concussed, and in some cases they (and their club) may attempt to circumvent the existing concussion laws. The NRL themselves note this and have consequently put in place fines for clubs that attempt to circumvent the concussion rules.

On Friday night the Broncos veteran Justin Hodges wasn’t concussed, but he did suffer a lower back injury as a result of an awkward tackle. After trying to stay on the field, despite being in considerable pain, he finally succumbed and went into the sheds. The Channel Nine commentators speculated as to whether he would be back or not.

Of course Hodges did come back on the field. Despite clearly being in great discomfort, he was able to finish the match, thanks to a well-directed pain-killing injection, something Hodges freely admitted to in the post-match interview.

Pain-killing injections are nothing new in professional sport. We all know they are prevalent and we don’t bat an eyelid when players like Hodges admit to taking them to enable them to keep playing.

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Indeed we approve by commending the bravery of players who continue playing through pain.

We all know and approve of this, despite the fact that some of the injuries being masked by the pain-killers may later manifest in some pretty debilitating diseases, like arthritis.

For example, normally a disease associated with old age, some former league players have serious arthritis in their forties and players as high profile as Nathan Hindmarsh and Luke Lewis were first diagnosed with arthritis while still playing.

Earlier in the season Dylan Walker was praised (including by myself) for playing almost an entire match against the Tigers with a broken hand. Of course, pain-killing injections would have helped him through it, but there is no denying that he played through (and scored two tries) despite being in excruciating pain.

This was one of the many incredible stories that rugby league has amassed over the years of players flighting through the pain barrier. It’s one of the things that makes rugby league such an amazing sport. It’s something that makes us all proud of our players, our clubs, our sport.

I do wonder though, about the long-term consequences.

Pain is one of the body’s key protection mechanisms. With pain killers you switch off this protection system, allowing the body to continue despite being under significant pain.

Doctors (and of course clubs) know that the injury suffered by their charges may be due to problems with tissues, muscles and bones. They also know that if they allow the athlete to continue training and competing with pain killing medications, there will most probably be irreversible or long-term effects.

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So much for “protecting players from themselves”.

Perhaps in ten or fifteen years, Walker may experience significant pain, discomfort or loss of use in that broken hand. Perhaps, to paraphrase Nathan Hindmarsh, the long-term effects of his injuries may cause him to feel “like an 80 year old”.

Perhaps in ten or fifteen years, Walker will decide that playing almost an entire match with a broken hand wasn’t such a great idea after all.

I don’t have all the answers, but I do know that it is hypocritical talking about player welfare in relation to concussion, but not applying the same analogy when it comes to potentially debilitating long-term injuries that are masked by pain killers.

And it’s also hypocritical of clubs (including my own, South Sydney) turning a blind eye to the consequences of the use of pain-killers, while also facilitating and enabling their use.